Comprehensive Detection of Candidate Pathogens in the Lower Respiratory Tract of Pediatric Patients With Unexpected Cardiopulmonary Deterioration Using Next-Generation Sequencing
Comprehensive Detection of Candidate Pathogens in the Lower Respiratory Tract of Pediatric Patients With Unexpected Cardiopulmonary Deterioration Using Next-Generation Sequencing
复制标题
使用下一代测序全面检测患有意外心肺恶化的儿科患者下呼吸道中的候选病原体
DOI：
10.1097/pcc.0000000000002558
复制
发表时间：
2020
影响因子：
4.1
通讯作者：
Ito Yoshinori
中科院分区：
文献类型：
--
作者：
Takeuchi Suguru;Kawada Jun-ichi;Horiba Kazuhiro;Yamaguchi Makoto;Okumura Toshihiko;Suzuki Takako;Torii Yuka;Kawabe Shinji;Wada Sho;Ikeyama Takanari;Ito Yoshinori
目标：下一代测序已应用于多种临床环境中的微生物研究。我们调查了呼吸道标本中的感染病因，从儿科患者意外心肺恶化使用下一代sequencing.Design：回顾性，单中心，observational study.Setting：三级保健，儿童hospital.Subjects：本研究共招募了16名儿科患者意外心肺恶化谁被送入PICU。10支气管肺泡灌洗液和6个经气管穿刺样本进行了分析。干预：无。测量和主要结果：RNA文库的标本制备和分析使用下一代测序。在10例患者的支气管肺泡灌洗液或经气管抽吸物标本中检测到一种或多种细菌/病毒病原体。细菌和病毒合并感染被认为是在4例。与常规培养和病毒抗原检测结果相比，新一代测序鉴定出额外的6种细菌和4种病毒病原体。相反，在通过常规方法鉴定的18种病原体中，通过下一代测序检测到9种病原体。候选病原体（如，柯萨奇病毒A6和沙眼衣原体）检测下一代测序的10例患者中，没有致病病原体已被确定由常规methods.Conclusions：我们的研究结果表明，病毒和细菌感染是常见的触发器在意想不到的心肺恶化儿科患者。下一代测序有可能有助于澄清儿科危重病的病因。
Objectives:Next-generation sequencing has been applied to the investigation of microorganisms in several clinical settings. We investigated the infectious etiologies in respiratory specimens from pediatric patients with unexpected cardiopulmonary deterioration using next-generation sequencing.Design:Retrospective, single-center, observational study.Setting:Tertiary care, a children’s hospital.Subjects:The study enrolled a total of 16 pediatric patients with unexpected cardiopulmonary deterioration who were admitted to the PICU. Ten bronchoalveolar lavage fluid and six transtracheal aspirate samples were analyzed.Interventions:None.Measurements and Main Results:RNA libraries were prepared from specimens and analyzed using next-generation sequencing. One or more bacterial/viral pathogens were detected in the bronchoalveolar lavage fluid or transtracheal aspirate specimens from 10 patients. Bacterial and viral coinfection was considered in four cases. Compared with the conventional culture and viral antigen test results, an additional six bacterial and four viral pathogens were identified by next-generation sequencing. Conversely, among 18 pathogens identified by the conventional methods, nine pathogens were detected by next-generation sequencing. Candidate pathogens (eg, coxsackievirus A6 and Chlamydia trachomatis) were detected by next-generation sequencing in four of 10 patients in whom no causative pathogen had been identified by conventional methods.Conclusions:Our results suggest that viral and bacterial infections are common triggers in unexpected cardiopulmonary deterioration in pediatric patients. Next-generation sequencing has the potential to contribute to clarification of the etiology of pediatric critical illness.
探讨婴儿猝死的危险因素及其在感染炎症反应中的作用
影响因子：
7.3
作者：
C. Blackwell;Sophia M. Moscovis;S. Hall;C. Burns;R. Scott
通讯作者：
R. Scott
影响因子：
1.8
作者：
Benneyworth BD;Bennett WE;Carroll AE
通讯作者：
Carroll AE
影响因子：
4.6
作者：
Takeuchi, Suguru;Kawada, Jun-ichi;Ito, Yoshinori
通讯作者：
Ito, Yoshinori